Yıl 2018, Cilt 19, Sayı 4, Sayfalar 157 - 163 2018-10-26

ZOR ASTIM
SEVERE ASTHMA

Seda Beyhan SAĞMEN [1] , Berrin CEYHAN [2]

12 18

Astım havayolu inflamasyonu ile seyreden çeşitli klinik
özelliklere sahip bir hastalıktır. Dünyada yaklaşık 300
milyon insanı etkileyen bir inflamatuvar hastalıktır. Astım
semptomları alerjenler gibi risk faktörlerinden kaçınarak
ve etkili inhaler tedavi ile kontrol altına alınmaktadır.
Astımlı hastaların büyük bir çoğunluğu uygun tedavi
ile kontrol altına alınmaktadır. Astımlı hastaların %
5-10’unu oluşturan zor astım klinisyenler için tanımı
ve tedavisi hala zor bir grubu oluşturmaktadır. İş gücü
kaybı ve ekonomik maliyet açısından yüksektir. Uygun
tedaviye rağmen bazı olguların kontrolü zorlaşmaktadır.
Standart tedavi ile kontrol edilemeyen, steroide bağımlı
veya dirençli astım olgularını içermektedir. Astıma bağlı
ölümlerin çoğu ağır olan veya stabil olmayan grupta
görülmektedir. Heterojen bir hastalık olan astımda farklı
fenotipler vardır ve net olarak anlaşılmamıştır. Tedavi
yönetimi için multidisipliner yaklaşım gerekmektedir. Ağır
astım hastalığın ilk yıllarında veya yıllar sonra gelişebilir.
Ağır astımda fenotipe özgü tedaviler günümüzde önem
kazanmıştır ve tedavi maliyeti yüksektir. Genetik, çevresel
faktörler, yaş ve hastalık süresinin ağır astımda rolü
olduğuna dair kanıtlar vardır. Özellikle genetik ve çevresel
faktörler ağır astımda önemli rol oynamaktadır. Ağır astım
olduğu düşünülen hastalar dikkatle değerlendirilmelidir.
Birçok hastalık astımı taklit edebilir. Bu hastalarda
öncelikle astım tanısı doğrulanmalıdır. KOAH ve vokal
kord disfonksiyonu ayırıcı tanıda özellikle dikkat edilmesi
gerekli hastalıklardır. İkinci olarak hastanın tedaviye
uyumu gözden geçirilmelidir. Ardından sigara içimi,
atopik durum, çalışma ortamı ve aspirin aşırı duyarlılığı
gibi faktörler araştırılmalıdır. Aynı zamanda ek hastalıklar
gibi astım kontrolünü etkileyebilen durumlar gözden
geçirilmelidir. Astımı zorlaştıran durumlar tek tek
araştırılmalıdır. Bu derlemede ağır astım tanımı, ayırıcı
tanıların dışlanması, fenotipleri ve tedavi yaklaşımları ele alınmıştır.

Asthma is a common inflammatory disease that has wide

clinical characteristics of the airway of the lungs. Asthma

symptoms can be prevented by avoiding triggers like

allergens and by the effective inhaled treatment. The

majority of asthma patients can be treated effectively

by current medications. Difficult asthma is a distinct

entity of asthma, comprising approximately %5-10 of

asthmatic patients. Despite the high effective treatment,

the patients with asthma have disease that is poorly

controlled. Severe asthmatics account for up to half of

the cost for asthma. It will include asthma uncontrolled

by new standard therapy, steroid dependent, steroid

resistant asthma patients. Asthma related deaths

are seen especially in severe asthma group. Asthma

is a heterogeneous disease, consisting of different

phenotypes. It requires multidisciplinary approach for

treatment management. Severe asthma may suddenly

develop in early time in disease or overtime. There was an

evidence that severe asthma related to genetic factors,

environmental factors, age, inflammation, duration of

disease The genetic and environmental factors may

play a role in severe asthma management. Phenotypetargeted

therapy has an important role in severe asthma,

but it is associated with high treatment costs. At first

diagnosis of asthma must be confirmed COPD and vocal

cord dysfunction is needed to be particular interest in

differential diagnosis. Triggering factors such as smoking,

atopy, work place condition and aspirin hypersensitivity

should be evaluated. Comorbidities that may affect

asthma should be considered. This review examines

the definition of asthma, its differential diagnosis,

phenotypes and available treatment options.

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Yazar: Seda Beyhan SAĞMEN (Sorumlu Yazar)

Yazar: Berrin CEYHAN

Bibtex @derleme { kocatepetip475027, journal = {Kocatepe Tıp Dergisi}, issn = {1302-4612}, eissn = {2149-7869}, address = {Afyon Kocatepe Üniversitesi}, year = {2018}, volume = {19}, pages = {157 - 163}, doi = {10.18229/kocatepetip.475027}, title = {SEVERE ASTHMA}, key = {cite}, author = {SAĞMEN, Seda Beyhan and CEYHAN, Berrin} }
APA SAĞMEN, S , CEYHAN, B . (2018). SEVERE ASTHMA. Kocatepe Tıp Dergisi, 19 (4), 157-163. DOI: 10.18229/kocatepetip.475027
MLA SAĞMEN, S , CEYHAN, B . "SEVERE ASTHMA". Kocatepe Tıp Dergisi 19 (2018): 157-163 <http://dergipark.gov.tr/kocatepetip/issue/39979/475027>
Chicago SAĞMEN, S , CEYHAN, B . "SEVERE ASTHMA". Kocatepe Tıp Dergisi 19 (2018): 157-163
RIS TY - JOUR T1 - SEVERE ASTHMA AU - Seda Beyhan SAĞMEN , Berrin CEYHAN Y1 - 2018 PY - 2018 N1 - doi: 10.18229/kocatepetip.475027 DO - 10.18229/kocatepetip.475027 T2 - Kocatepe Tıp Dergisi JF - Journal JO - JOR SP - 157 EP - 163 VL - 19 IS - 4 SN - 1302-4612-2149-7869 M3 - doi: 10.18229/kocatepetip.475027 UR - http://dx.doi.org/10.18229/kocatepetip.475027 Y2 - 2018 ER -
EndNote %0 Kocatepe Tıp Dergisi SEVERE ASTHMA %A Seda Beyhan SAĞMEN , Berrin CEYHAN %T SEVERE ASTHMA %D 2018 %J Kocatepe Tıp Dergisi %P 1302-4612-2149-7869 %V 19 %N 4 %R doi: 10.18229/kocatepetip.475027 %U 10.18229/kocatepetip.475027
ISNAD SAĞMEN, Seda Beyhan , CEYHAN, Berrin . "ZOR ASTIM". Kocatepe Tıp Dergisi 19 / 4 (Ekim 2018): 157-163. http://dx.doi.org/10.18229/kocatepetip.475027